The Effectiveness of Attached Social Workers in the Management of Depressed Women in General Practice

Summary Following early reports of the feasibility and usefulness oflocating social workers in general practice (Collins, 1965;Forman and Fairbairn, 1968; Cooper, 1971) the number of attachmentsto general practice has increased markedly over the last decade(Gilchrest et al., 1978). Although there have been a numberof accounts of the increased co-operation between health carestaff (Clare and Corney, 1982) there has been a dearth of objectiveevaluations of the advantages these schemes bring to generalpractice patients. This paper describes the design, executionand outcome of a clinical trial of social work carried out ondepressed women in general practice aged 18–45. It focuseson the social workers' activities and the clients view of help:more detailed information is described elsewhere (Corney, 1981).     

Interaction Between Field and Residential Social Workers

Summary This paper is based upon collaborative project work with a socialservices department aimed at improving interaction and collaborationbetween field and residential social workers. It describes theprinciples upon which it was agreed that interaction shoulddevelop. These include notions of case-accountable staff, acollateral model of interaction between staff and the idea ofone party being identified as a prime care agent. Based on theseprinciples it sets out a model arrangement for clients enteringresidential care which recognizes the need for precision aboutthe nature of key decisions that need to be taken with clientsand the way these decisions should be taken.     

No more than Contact: An Outcome of Social Work

Summary This study of the experiences of eight sets of clients withtheir respective social workers illustrates how the outcomeof each case is a reflection of each party's interpretationsof crucial aspects of their meetings. In many respects it isa one-sided picture of social work but part of its purpose isto emphasize the process whereby past events and present circumstancesaffecting both parties' perspectives make it probable that manyclients will fail to obtain help and will regard their meetingswith social workers as being little different from passing contactswith other 'officials' who feature in their lives.     

The Social Work Task in an Acute Psychiatric In-Patient Unit

Summary This paper reports the results of monitoring all admissionsfrom a prescribed geographical area to an acute psychiatricin-patient unit for a six month period. Members of the hospitalsocial work department assessed all admissions and selectedapproximately one-half of these for high social work input Demographicdata for the whole subject group is examined and compared tothe high input group. The case review system outlined by Goldbergand Fruin (1976) is used to describe the clients' social problemson admission, as well as the social work task, in terms of practicalservices and other social worker activities. These findingsare compared to those of Goldberg et al. (1977) who examinedthe social work task in an area office social services departmentintake team. Despite differences in demographic profiles ofthe two groups and consequently differing social problems, thesocial work task in both settings was found to be similar. Inboth studies 53% of clients were offered some practical (althoughdifferent service) and the most common social work activitieswere found to be assessment, information and advice, and mobilizingresources.     

The Significance of the Early Stage of Illness as a Focus for Social Work Help

Summary This paper considers the experience of illness as a series ofinterrelated phases, in which the beginning phase which is thetransition from health to illness is shown to have special significance.The common responses to this stage of illness are denial, welcomeor inertia, each of which may give some forewarning of problemsthat may be encountered later in the illness. Traditionallysocial work help has focused onto the acute or convalescentstages, but it is suggested here that the beginning phase ofillness offers a rewarding point for intervention, not onlywhen opening new cases, but also among clients who are alreadyknown and where health problems may interact with other problems.The implications of this are explored both for agency policyas well as an added dimension of diagnostic understanding ofindividual clients no matter what the agency     

Aspects of Social Work on a Cancer Research and Treatment Unit in a London Teaching Hospital

Summary With the rapid growth of technology and science in society today,an increasingly large number of people are becoming patientsin specialized research and treatment units. The reorganizationof social work support to the health service is upon us, andgreat care must be taken to ensure that this important groupof clients will receive the social work help it needs. The paper is based on work in a cancer unit in a London teachinghospital and seeks to illustrate ways in which the work is specialized     

Specialism, Genericism and Others: Does it Make a Difference? A Study of Social Work Services to Elderly People

Correspondence should be addressed to Roger Fuller, Social Work Research Centre, University of Stirling, Stirling, FK9 4LA Summary A previous paper published in this journal (Fuller and Petch,1991) described a preliminary feasibility study designed toinvestigate the effects of organizing social work teams alongspecialist or generic lines. The main study which developedfrom this work is here reported. The study, using modified casereview forms, compares the way samples of referrals of elderlypeople (n=1232) were dealt with at initial assessment and forup to a year subsequently by 15 social work teams of contrastingorganizational approach. The latter include specialist and genericteams, and comparisons are also drawn with teams adopting aself-styled community social work approach. Although the organizationalagenda has moved on since the study began, the issues are ofcontinuing relevance for the implementation of community care,particularly in view of its growing focus on specialist services.While not arguing that there is any one optimal model of teamorganization, the paper sets out some of the measurable consequencesof opting for the various models; in particular, it emergesthat the strengths of specialization are more clearly apparentin certain aspects of their engage ment with clients than inothers and at certain stages of that engagement than at others.     

From Values of Rights in Social Work: Some Issues in Practice Development and Research

Prof. E. Sainsbury. Dept. of Sociological Studies. University of Sheffield. Sheffield S10 2TN. Summary The following is a discussion paper prepared for a researchteam engaged in a project funded by the Joseph Rowntree MemorialTrust. The problems it sought to address concerned how the teamcould derive a clear statement of clients rights from broadformulations of professional values, and the extent to whichresearch can measure the realization of these rights in socialwork practice. It was found in the research that the practical wisdom (commonsense) of social workers is frequently assumed to be based onprofessionally agreed values, and that—in the pressuresof daily work —values are seldom articulated in ways whichchallenge the procedures and solutions dictated by common sense.Thus, an initial purpose in preparing the paper was to commenton ways in which matters concerned with values become obscuredin practice, and to find ways of linking together values. rightsand practice more strongly. In offering this paper for widerpublication. the research team hopes that it will stimulatecomments which will assist their thinking.     

'Problematics of Government', (Post) Modernity and Social Work

Correspondence to Nigel Parton, Professor in Child Care Studies, The University of Keele, Keele. Staffordshire ST5 5BG. Summary This paper attempts to locate contemporary developments andtensions in social work within current debates in social theoryconcerning the problematics of government and (post) modernity.It argues that modern social work emerged in a period of ‘welfarism’which has now passed and that as a consequence social work hasnot simply been restructured in the era of neo-liberalism butis exposed as an activity particularly concerned with managingfamily life via the exercising of moral judgements and negotiatingresponsibilities. As a consequence the essential ambiguitiesof social work are more self evident than previously, and ratherthan constituting problems to be overcome, articulate the centralelements of what it is to do social work. The article concludesby, tentatively, outlining the implications of such an analysisand how it may help us to understand what is going on and howwe might proceed.     

Long Term Care for the Elderly: the Community Care Scheme

Summary The article describes the full evaluation of the Community CareScheme for the elderly in Kent. The evaluation compared therelative cost-effectiveness of the scheme for clients and carerswith the range of services which would otherwise have been received.It is argued that effective case-management by a key workeris an essential feature of more effective home care for thevery frail elderly and that the case-management role is an appropriatemodel of social work for other long term care groups. The newscheme appeared particularly appropriate for the extremely mentallyand physically frail who were living with others and for theless frail, socially isolated elderly person prone to minorpsychiatric disorder.     

Social Work and Child-centred Family Court Mediation

Correspondence to Dr Greg Mantle, APU, Ashby House, Floor 2, Brook Street, Chelmsford CM1 1UH, UK. E-mail G.J.Mantle{at}apu.ac.uk Summary In April 2001, the Children and Family Court Advisory SupportService (CAFCASS) became responsible for family court work,including the provision of mediation services. Family courtmediation offers a gateway for social work with children andfamilies whose needs are largely left untouched by current services,and could thereby play an important part within the broaderextension of prevention, early intervention, parenting and supportservices recommended by government. Over the past two decades,mediation has become a popular approach to reducing conflictand resolving disputes in a wide range of inter-personal, communityand organizational settings. Given the professional interestthat social workers have in helping their clients achieve moreharmonious lives, the space for mediation would appear considerableand yet the connections between mediation and social work are,as yet, insufficiently mapped and analysed, in terms of boththeory and practice. This paper draws on literature and recentresearch to review the relationship between family court mediationand social work.     

The Limits of Radical Social Work

Summary Doubts raised by research evaluation of traditional caseworkhave been increased by the perception by radical social workersthat some clients' difficulties derive from their involvementwith state machinery rather than personal capacity or circumstances,and that many can be helped by working collectively with othersin their community rather than striving alone in a dependentrelationship with a caseworker. Radical aspirations, however,assume that all clients have the capacity to overcome theirdifficulties and that none are so damaged as to be able realisticallybarely to cope with them. The radicals' doubts about the usefulnessof individual support and emphasis on collective self help raisethe danger of neglecting those who are unable to participateeffectively and gain from such efforts.     

Family Placements for People with a Learning Difficulty: A Study using Time Budgets

Correspondence to Dr R. F. Drewett, Department of Psychology, University of Durham, Science Building, South Road, Durham DH1 3LE. Summary The Durham County Council Family Placement Scheme offers long-termcare in families for adults with learning difficulties. Theactivities of the twenty-four clients in family placements werestudied using interviews and diaries kept by carers. Althoughmost of the clients were only mildly handicapped three wereseverely disabled. Most of the carers have either professionalor voluntary experience of work with people with learning difficulties.Although four of the placements have broken down, the levelsof activity of the clients still in their families were similarto those found in other types of community-based care, and werejust as extensive in the more disabled. The previous experienceof the carer had no clear relationship with the activity levelsof the client.     

The Impact of Criminal Conviction Disclosure on the Self-reported Offending Profile of Social Work Students

Correspondence to University of Edinburgh, School of Social and Political Studies, 31 Buccleuch Place, Edinburgh, EH8 9JT, UK. E-mail: richard.perry{at}ed.ac.uk. Summary Data gathered at a Scottish institute of higher education between1986 and 2000 indicate a significant reduction in the scaleof self-reported offending behaviour by social work students.The change coincided with the introduction by the Central Councilfor Education and Training in Social Work (CCETSW) in 1989 ofa requirement that applicants for training disclose prior toadmission any criminal convictions recorded against them. Thearticle suggests that more prolific offenders have been deterredfrom applying to DipSW programmes and the social work professionneeds to take steps to create a more positive climate for therecruitment of those offenders who represent no more of a threatto users than non-offenders.     

Social Work as an Aspect of Primary Health Care: The Social Workers' View

Summary This study is based on an analysis of social workers' viewsof their work with 168 clients referred over a six month periodin 1977 in a health centre setting. A wide range of referralswas made and there was close collaboration with other primaryhealth care professionals as well as outside agencies. Far morepsycho-social problems were encountered by the social workersin the course of their intervention than were apparent on referral,although most of the work was short term. Social work with theindividual predominated and a variety of traditional socialwork skills were employed, although the elderly received relativelylittle help with emotional problems and were offered mainlypractical help. Social workers' perceptions of their clientsare discussed in relation to their choice of methods of interventionand feelings of efficacy. The attachment scheme emerges as generallyfruitful both in terms of social workers' job satisfaction andclients benefitting from a multi-disciplinary approach; howeverthe need for closer inter-professional collaboration in meetingthe needs of the elderly is highlighted.     

Beyond Retroduction? -- Hermeneutics, Reflexivity and Social Work Practice

Correspondence to Susan White, University of Manchester, Department of Social Policy and Social Work, Williamson Building, Oxford Road, Manchester Summary Over the last three decades qualitative research methodologieshave been in the ascent within social science. Yet social workevaluation studies have tended to be quantitative in nature,conventially relying upon the generation of criteria againstwhich interventions are retrospectively judged. The generationof such criteria inevitably depends upon pre-suppositions, whichin themselves go unresearched. As a consequence the .sense makingactivities on which social work interventions depend are renderedimmune from critical analysis. This reflects a broader tendencyfor social work to cling to naive realist epistemologies, whichare arguably obsolete within the interpretive paradigm in whichits activity is properly located. By examining the debates withininterpretive social science, this paper argues for an approachto social work assessment which avoids the pitfalls of naiveobjectivism and the nihilism of anarchic relativism, whilstretaining creativity, imagination and hope.     

Service Users and Practitioners Reunited: The Key Component for Social Work Reform

Correspondence to Professor Peter Beresford, Centre for Citizen Participation, Brunel University, Osterley Campus, Borough Road, Osterley, Middlesex, TW7 5DU, UK. E-mail: peter.beresford{at}brunel.ac.uk or Suzy Croft, Senior Social Worker, St John's Hospice, 60 Grove End Road, London, NW8 9NH, UK. E-mail: suzy.croft{at}hje.org.uk Summary This article explores the pressures towards both regulatoryand liberatory social work. It identifies a range of factorsoperating to push social work in each direction. It discussesthe key significance for more liberatory social work of theroles and engagement of social work practitioners and serviceusers. Highlighting four key characteristics in the currentpolitical and policy context of social work: ambiguity, uncertainty,complexity and contradiction, it argues that social work isunlikely to develop a more emancipatory role, unless socialwork practitioners gain more support to play a central rolein its construction and develop much closer links and allianceswith service users and their organizations and movements.     

Keeping Social Work Honest: Evaluating as Profession and Practice

Correspondence to Ian Shaw, School of Social and Administrative Studies, University of Wales Cardiff, 50 Park Place, Cardiff CF1 3AT Summary The central argument of this paper is that social work needsa radical alternative to existing options for evaluating practice.Social workers at present are offered three choices. They areinvited to choose between applying research, conducting researchor adopting specific forms of empirical research-based practice(for example Everitt et al., 1992; Thyer. 1993; Fuller and Petch,1995). We touch briefly on reasons why we believe none of these optionsprovides an adequate grounding for social work, referring especiallyto the growing call for social work to find new purpose throughan empirical, research-based practice. If alternative approachesare to be persuasive, they must be fashioned from the materialsof a new approach to research on social work practice—‘one that is exploratory rather than confirmatory, buildinga model of evaluation from the practitioners' own accounts ratherthan superimposing an ideal model’ (Elks and Kirkhart,1993, p. 555). The major part of this paper is taken up withevidence from research of this kind. The model of evaluatingin practice with which we conclude the paper is simultaneouslytrue to social workers' accounts of their practice, while offeringa critical starting point for evaluating and refashioning thatpractice.     

Reading Social Work Competing Discourses in the Rules and Requirements for the Diploma in Social Work

Correspondence to Dr Beth Humphnes, Department of Applied Community Studies, Manchester Metropolitan University, 799 Wilmslow Road, Manchester M20 2RR Summary The changes which have taken place across all of social workeducation and practice in Britain introduce a new phase forthe profession in line with wider political and economic changesin the UK. The Rules and Requirements for the Diploma in SocialWork exemplify these changes, and the document containing themis a useful focus for an analysis of what is at stake. Thisarticle employs discourse analysis to examine the ideologicalfunctions of the Dip.S.W. regulations and their relationshipto wider social discourses, having in mind both the discipliningrole of discourse and its possibilities for transformation.It identifies a dominant regulatory discourse, and an oppositionalliberatory discourse which are in dialogue with each other andwith related discourses. The article considers the constructionof social work in the document in its surveillance, managerialist,competence-based functions. The analysis also looks for contradictoryvoices in these discourses and in CCETSW'. Welsh Language Policyand Equal Opportunities Statement, which might offer sites ofresistance and refusal. It is argued that the shape of the stagesocial work has entered into is not inevitable, and the destabilizingpotential of such an analysis creates a space for the imaginationof alternatives.     

Long Term Social Work in a Primary Health Care Setting

Summary This study was designed to explore which factors characteriselong term clients and to investigate the relationship betweenthe burden on medical and welfare resources in a general practicesetting. Two groups of clients were studied; 135 long term clientsreferred over a five year period, where contact was maintainfor a minimum of one year and 157 cases referred during a sixmonth period, in all of which the duration of social work interventionwas less than 12 months. Few differences were found betweenthe characteristics of the two groups, nor did any individualsocial worker emerge as being particularly predisposed to maintainlong term contact However, a significant change in the proportionof referrals which became long term was found over the fiveyear period under consideration, and policy regarding the handlingof cases was therefore felt to constitute a major influenceon the length of contact with any particular client Relationshipswith other members of the primary health care team were generallyfound to be good, especially in relation to the long term clients.Moreover, the OPs' workload with regard to these clients wasfound to be reduced following social work intervention. Theseclients' consultation rates dropped significantly after receivingsocial work help, and continued to drop when the case had beenclosed.